Anchoring cannula

ABSTRACT

An apparatus and method for an anchoring cannula including a first cannula having a proximal end, a distal end, a longitudinal axis and a lumen extending from the proximal end to the oppositely disposed distal end along the longitudinal axis. A second cannula is concentrically arranged within the lumen of the first cannula, the second cannula having a proximal end, a distal end and a lumen extending from the proximal end to the oppositely disposed distal end along the longitudinal axis. The second cannula includes an expandable portion connected to the distal end that is configured to expand when the second cannula is advanced out of the distal end of the first cannula and to change to an unexpanded configuration when retracted back into the distal end of the first cannula.

TECHNICAL FIELD

The present disclosure provides cannulas for use in surgical proceduresand, more particularly, to an anchoring cannula possessing a material onor as part of a portion thereof which alters its configuration upon thedeployment to anchor the cannula to tissue upon insertion in a patient'sbody. Methods of using such a cannula are also provided.

BACKGROUND

During minimally invasive surgical procedures, cannulas are utilized toprovide an access port for surgical instruments and for treatingconditions such as fractures. A sharp trocar may be positioned withinthe cannula and utilized to puncture or pierce the tissue to access thedamaged bone. Thereafter the trocar may be removed, leaving the cannulain place providing the access port to the site of treatment.Stabilization of the cannula during treatment is very important, as theports can be accidentally ejected from the patient or moved whilematerials, such as bone cement, are being delivered resulting in lessperfect treatment and increased procedure time.

In the bone where there is minimal cancelous bone, such as a distalradius, when the cannula is inserted, it cannot be easily stabilized anddoes not remain stationary. This unstabilization can cause imprecisedisbursement of material, such as bone cement. To increasestabilization, use of an anchoring cannula at the surgical site adjacentto a fracture or a break in a portion of a bone is needed.

SUMMARY OF THE INVENTION

This application relates to an apparatus and method for an anchoringcannula having a first cannula including a proximal end, a distal end, alongitudinal axis and a lumen extending from the proximal end to theoppositely disposed distal end along the longitudinal axis. A secondcannula is concentrically arranged within the lumen of the firstcannula. The second cannula having a proximal end, a distal end and alumen extending from the proximal end to the oppositely disposed distalend along the longitudinal axis. The second cannula includes anexpandable portion connected to the distal end that is configured toexpand when the second cannula is advanced out of the distal end of thefirst cannula and to return to an unexpanded configuration whenretracted back into the distal end of the first cannula.

In one embodiment, an anchoring cannula includes an outer cannula havinga proximal end, a distal end, a longitudinal axis and a lumen extendingfrom the proximal end to the oppositely disposed distal end of the outercannula along the longitudinal axis. Each of the proximal and distalends includes an opening therein. An inner cannula configured to fitwithin the lumen of the outer cannula is provided. The inner cannulahaving a proximal end, a distal end, a longitudinal axis and a lumenextending from the proximal end to the oppositely disposed distal endalong the longitudinal axis. The distal end includes an expandableportion connected to the distal end that is configured to expand whenthe inner cannula is advanced out of the distal end of the outer cannulaand to collapse when retracted back into the outer cannula. Theexpandable portion is constructed of polymer and shapeset material thatexpands when the inner cannula is advanced out of the distal end of theouter cannula and collapses when the retracted back into the outercannula. An actuator member is in contact with the inner cannula whereinmoving the actuator back and forth from a first position to a secondposition extends and retracts the expandable portion of the innercannula from the distal end of the outer cannula. The anchoring cannulafurther includes a locking mechanism configured to lock the innercannula to the outer cannula.

A method for treating a fracture including inserting the anchoringcannula of the present disclosure into bone adjacent to a fracture isalso provided. The method includes advancing the second cannula out ofthe distal end of the first cannula to expand the expandable portion sothat the at least a part of the expandable portion is in contact withbone so as to stabilize the anchoring cannula in place. Treating thefracture adjacent to the anchoring cannula. Retracting the secondcannula back into the distal end of the outer cannula so as to collapsethe expandable portion of the second cannula and removing the anchoringcannula from bone.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure will become more readily apparent from thespecific description accompanied by the following drawings, in which:

FIG. 1 is a perspective view of the anchoring cannula in accordance withthe principles of the present disclosure;

FIG. 2 is a cross sectional view of one particular embodiment of theanchoring cannula of FIG. 1 along the lines II-II;

FIG. 3 is a perspective view of the anchoring cannula of FIG. 1 with theexpandable portion disposed outside of the inner cannula but notexpanded;

FIG. 4 is a perspective view of the anchoring cannula of FIG. 3 with theexpandable portion beginning to expand to its expanded configuration;

FIG. 5 is a perspective view of the anchoring cannula of FIG. 4 with theexpandable portion fully expanded;

FIG. 6 is a perspective view of the distal end of the anchoring cannulaof FIG. 1;

FIG. 7 is a perspective view of the anchoring cannula of FIG. 1 disposedin a surgical site; and

Like reference numerals indicate similar parts throughout the figures.

DETAILED DESCRIPTION

An apparatus and method is described for an anchoring cannula. Forillustrative purposes, the apparatus and method shall be described inthe context of injecting a bone void filler/bone cement into a portionof a long bone or vertebra of a patient to treat bone fractures,although the apparatus and methods can be used to treat otherconditions.

The present disclosure may be understood more readily by reference tothe following detailed description of the disclosure taken in connectionwith the accompanying drawing figures, which form a part of thisdisclosure. It is to be understood that this disclosure is not limitedto the specific devices, methods, conditions or parameters describedand/or shown herein, and that the terminology used herein is for thepurpose of describing particular embodiments by way of example only andis not intended to be limiting of the claimed disclosure. Also, as usedin the specification and including the appended claims, the singularforms “a,” “an,” and “the” include the plural, and reference to aparticular numerical value includes at least that particular value,unless the context clearly dictates otherwise. Ranges may be expressedherein as from “about” or “approximately” one particular value and/or to“about” or “approximately” another particular value. When such a rangeis expressed, another embodiment includes from the one particular valueand/or to the other particular value. Similarly, when values areexpressed as approximations, by use of the antecedent “about,” it willbe understood that the particular value forms another embodiment. It isalso understood that all spatial references, such as, for example,horizontal, vertical, top, upper, lower, bottom, left and right, distaland proximal, are for illustrative purposes only and can be variedwithin the scope of the disclosure. For example, the references “upper”and “lower” are relative and used only in the context to the other, andare not necessarily “superior” and “inferior”.

Further, as used in the specification and including the appended claims,“treating” or “treatment” of a disease or condition refers to performinga procedure that may include administering one or more drugs to apatient (human, normal or otherwise or other mammal), in an effort toalleviate signs or symptoms of the disease or condition. Alleviation canoccur prior to signs or symptoms of the disease or condition appearing,as well as after their appearance. Thus, treating or treatment includespreventing or prevention of disease or undesirable condition (e.g.,preventing the disease from occurring in a patient, who may bepredisposed to the disease but has not yet been diagnosed as having it).In addition, treating or treatment does not require complete alleviationof signs or symptoms, does not require a cure, and specifically includesprocedures that have only a marginal effect on the patient. Treatmentcan include inhibiting the disease, e.g., arresting its development, orrelieving the disease, e.g., causing regression of the disease. Forexample, treatment can include reducing acute or chronic inflammation;alleviating pain and mitigating and inducing re-growth of new ligamentand/or bone, repairing a fracture or break in bone and other tissues; asan adjunct in surgery; and/or any repair procedure. Also, as used in thespecification and including the appended claims, the term “tissue”includes soft tissue, ligaments, tendons, cartilage and/or bone unlessspecifically referred to otherwise.

The following discussion includes a description of an anchoring cannulafor treating fractures, including using an inflatable bone tamp, drillsand for delivering bone void filler, such as, for example, auto graft,allograft, demineralized bone material, mineral composites, blocks,granules and pellets and bone cement, such as, for example, PMMA-basedmaterial (HVR, Activos, Activos 10, Spine-05), Calcium Phosphate(Skaffold, Norian, Hydroset, Kyphos FS) and Calsium Sufacte (WrightMedical), as well as other injectables. It also includes a descriptionof related methods of employing the anchoring cannula in accordance withthe principles of the present disclosure. Alternate embodiments are alsodisclosed. Reference will now be made in detail to the exemplaryembodiments of the present disclosure, which are illustrated in theaccompanying figures. Turning now to FIGS. 1-7, there is illustratedcomponents of an anchoring cannula 20 in accordance with the principlesof the present disclosure.

The components of the anchoring cannula 20 can be fabricated frombiologically acceptable materials suitable for medical apparatuses,including metals, synthetic polymers, ceramics, thermoplastic andpolymeric material and/or their composites. For example, the componentsof the anchoring cannula 20, individually or collectively, can befabricated from materials such as stainless steel alloys, commerciallypure titanium, titanium alloys, Grade 5 titanium, super-elastic titaniumalloys, cobalt-chrome alloys, stainless steel alloys, superelasticmetallic alloys (e.g., Nitinol, super elasto-plastic metals, such as GUMMETAL® manufactured by Toyota Material Incorporated of Japan, Fe—Mn—Siand Fe—Ni—Co—Ti composites), ceramics and composites thereof such ascalcium phosphate (e.g., SKELITE™ manufactured by Biologix Inc.),thermoplastics such as polyaryletherketone (PAEK) includingpolyetheretherketone (PEEK), polyetherketoneketone (PEKK) andpolyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO₄ polymericrubbers, polyethylene terephthalate (PET), fabric, silicone,polyurethane, silicone-polyurethane copolymers based materials,polymeric rubbers, polyolefin rubbers, semi-rigid and rigid materials,thermoplastic elastomers, thermoset elastomers, elastomeric composites,rigid polymers including polyphenylene, polyamide, polyimide,polyetherimide, polyethylene, epoxy, polyacrylate and composites ofmetals and calcium-based ceramics, composites of PEEK and calcium basedceramics, and combinations of the above materials. Various components ofthe anchoring cannula may have material composites, including the abovematerials, to achieve various desired characteristics such as strength,rigidity, elasticity, compliance, and biomechanical performance,durability and to provide a non-stick surface. The components of theanchoring cannula system 20 may be monolithically formed, integrallyconnected or include fastening elements and/or coupling components, asdescribed herein.

As will be described fully herein, one embodiment of the presentdisclosure incorporates and utilizes one or more material(s), whichexhibit what is known as “superelasticity”. The term “superelasticity”,as used herein, shall generally mean the ability of a material toundergo large elastic deformations without the onset of plasticity orpermanent deformation.

One particular group of metallic alloys, known as “shape memory alloys”is known to exhibit superelastic properties. Such shape memory alloysalso demonstrate a “shape memory” phenomenon whereby the alloy isgenerally transformable, back and forth, between a low temperatureconfiguration and a high temperature configuration. Transformation fromthe low temperature configuration to the high temperature configurationgenerally occurs as the alloy passes from its martensitic state to itsaustenitic state. Subsequent transformation from the high temperatureconfiguration back to the low temperature configuration occurs as thealloy passes from its austenitic state to its martensitic state.

These unique alloys also show a superelastic behavior if deformed at atemperature which is slightly above their transformation temperatures.This effect is caused by the stress-induced formation of some martensiteabove its normal temperature. Because it has been formed above itsnormal temperature, the martensite reverts immediately to undeformedaustenite as soon as the stress is removed. This process provides a veryspringy, “rubberlike” elasticity in these alloys.

In one embodiment, as shown in FIGS. 1-7 anchoring cannula 20 includes afirst cannula, such as, for example an outer cannula 22 and a secondcannula, such as, for example, an inner cannula 32. Outer cannula 22extends between a proximal end 24 and a distal end 26 along alongitudinal axis L. In an alternate embodiment, a portion of the innerand outer cannula, 22, 32, can have alternate orientations relative tolongitudinal axis L, such as, for example, parallel, transverse and/orother angular orientations such as acute or obtuse, co-axial and/or maybe offset or staggered. Outer cannula 22 includes an inner surface 21and an outer surface 23. Inner surface 21 defines a lumen 28 thatextends along longitudinal axis L between proximal end 24 and distal end26.

It is contemplated that outer cannula 22 be variously configured, suchas, for example, round, oval, oblong, square, rectangular, polygonal,irregular, uniform, non-uniform, offset, staggered, tapered, consistentor variable, depending on the requirements of a particular application.Outer surface 23 may be rough, arcuate, undulating, mesh, porous,semi-porous, dimpled and/or textured according to the requirements of aparticular application

Proximal end 24 and distal end 26 each include an opening 25 and 27.Openings 25 and 27 can be variously configured, such as, for example,round, oval, oblong, square, rectangular, polygonal, irregular, uniform,non-uniform, offset, staggered, tapered, consistent or variable,depending on the requirements of a particular application. Openings 25and 27 do not need to have the same shape but are configured to provideaccess to and out of lumens 28, 38 of inner and outer cannulae 22, 32.In one embodiment, in accordance with the disclosure, it is contemplatedthat outer cannula 22 includes a cutting edge at distal end 26configured to cut into the tissue wherein anchoring cannula 20 is to beused. In the alternative, distal end 26 can include a threaded portion,fluted tip as well as other surgical configurations. In the alternative,a separate device can be used to cut a primary access port for anchoringcannula 20 and the cutting edge shaves away at the edges of the primaryaccess point to gain entry into the surgical site.

Inner cannula 32 extends along longitudinal axis L between a proximalend 34 and a distal end 36 and inner cannula 32 is configured to fitwithin lumen 28, such as, for example, inner cannula 32 isconcentrically arranged within lumen 28 at least in part. It iscontemplated that inner cannula 32 can be variously configured, such as,for example, round, oval, oblong, square, rectangular, polygonal,irregular, uniform, non-uniform, offset, staggered, tapered, consistentor variable, depending on the requirements of a particular applicationas long as it fits within outer cannula 22. The surface of inner cannula32 can be coated with a lubricant to allow it to slide within lumen 28of outer cannula 22. Distal end 36 includes an expandable portion 40connected thereto that is further discussed below. The expandableportion 40 can be a separate member that is connected to the distal end36 of inner cannula 32 for example, it can be glued, heat-sealed ormechanically fastened. In the alternative, inner cannula 32 andexpandable portion 40 can be, at least in part, monolithically formed.

In one embodiment in accordance with the present disclosure, innercannula 32 includes an actuator mechanism 50 disposed at proximal end 24of outer cannula 22. Outer surface 23 of outer cannula 22 includes acavity, such as for example, an elongated slot 56 disposed at itsproximal end 24. Elongated slot 56 allows for movement of actuatormechanism along longitudinal axis L. Actuator mechanism 50 includes apin 58 that engages elongated slot 56. In one embodiment, pin 58 isconnected to inner cannula 32 so that movement of pin 58 by actuatormechanism 50 moves the inner cannula 32 in the direction of movement ofactuator mechanism 50. That is, actuator mechanism 50 moves alonglongitudinal axis L as shown by arrow A1, and slides from a firstposition thereby moving inner cannula 32 in the same direction. Movingactuator mechanism 50 in the A1 direction advances inner cannula 32 outfrom distal end 26 allowing expandable portion 40 to be in its expandedconfiguration. Advancing expandable portion 40 out of distal end 26,distal end 26 is no longer restricted from expanding by the walls oflumen 28 of outer cannula 22 and therefore expands to its expandedconfiguration. Moving actuator mechanism 50 back from the secondposition, as shown by arrow A2, slides actuator mechanism 50 back to thefirst position thereby retracting inner cannula 32 into distal end 26and returning expandable portion 40 to its unexpanded configuration.Actuator mechanism 50 includes a locking mechanism configured to lockinner cannula 32 in a position certain with respect to outer cannula 22.It is contemplated that locking mechanism is configured as cavity 52that is disposed transverse to elongated slot 56 such that actuatormechanism 50 can be rotated to move pin 58 into cavity 52 to preventaxial movement along longitudinal axis L.

In one embodiment, expandable portion 40 is entirely within outercannula 32 when in the collapsed configuration. At least a portion ofexpandable portion 40 contacts the inner surface 21 of outer cannula 22so as to maintain it in the collapsed configuration. In an alternativeembodiment, collapsed expandable portion 40 is positioned partiallywithin outer cannula 22 so that the walls of outer cannula 22 is incontact with the expandable portion keeping it in an unexpandedconfiguration. In this embodiment, the expandable portion 40 can betapered to facilitate entry into the surgical site. Once fully advancedfrom the outer cannula 22, expandable portion 40 expands to itsunexpanded configuration as discussed above.

It is contemplated that expandable portion 40 can be constructedexclusively of shapeset alloy, shape memory polymer with non-shapememory or with a polymeric material. Such shapeset materials possess apermanent shape and a temporary shape. The temporary shape of expandableportion 40 can be tapered so as to make it easier to introduce thecannula into a patient's body. The permanent shape is an expandedconfiguration, which enhances the retention of the cannula at the siteof the procedure.

As stated above, the expandable portion 40 may also have polymericmaterials connected to the shapeset material such that polymericmaterials have shapeset material connecting them together to form theexpandable portion 40. The polymeric materials are rigid and once theshapeset material is allowed to expand the polymeric material providesadditional anchoring properties to the expandable portion 40. That is,the polymer segments of the expandable portion are configured to contactthe inner bone surfaces, for example cancelous bone, when in theexpanded sates so as to anchor the cannula in place. Suitable polymericmaterials to be used with the shapeset materials includes, for example,polyurethanes, poly(styrene-butadiene) block copolymers,polynorbornenes, caprolactones, dioxanones, diol esters includingoligo(epsilon caprolactone)diol, lactic acid, lactide, glycolic acid,glycolide, ether-ester diols including oligo(p-dioxanone)diol,carbonates including trimethylene carbonate, combinations thereof, andthe like. In one embodiment, the shape memory polymer may be a copolymerof two components with different thermal characteristics, such as oligo(epsilon-caprolactone)dimethacrylates and butyl acrylates includingpoly(epsilon-caprolactone)dimethacrylate-poly(n-butyl acrylate), or adiol ester and an ether-ester diol such as oligo(epsiloncaprolactone)diol/oligo(p-dioxanone)diol copolymers. These multi-blockoligo(epsilon-caprolactone)diol/oligo(p-dioxanone)diol copolymerspossess two block segments: a “hard” segment and a “switching” segmentlinked together in linear chains.

It is contemplated that expandable portion 40 be self-expanding due tothe spring forces inherent in the shapeset materials and design. In oneembodiment in accordance to the disclosure the shapeset material used inexpandable portion 40 is a Ni—Ti-based alloy such as Nitinol, or ironbased alloy such as Fe—Mn—Si or Fe—Ni—Co—T, copper-aluminum-nickel(CU—Al—Ni), copper-zinc-aluminum (Cu—Zn—Al) and Fe—Mn—Si—Cr. Withshapeset materials, the shape of expandable portion 40 can bepredetermined. Additionally, expandable portion 40 can be retrieved,repositioned, or removed by retracting the distal end back into theouter cannula 22 thereby forcing expandable portion 40 into itsunexpanded configuration. Expandable portion 40 can have a materialcross section in the shape of a rectangle, circle, triangle, trapezoid,or any other shape providing a desired bone interaction. Expandableportion 40 can be configured to exhibit different expansion properties,such that expansion results in a non-cylindrical profile (e.g.,outwardly tapering, inwardly tapering, ovoid, peanut-shaped, etc.). Itis contemplated that at least the expandable portion 40 of the innercannula 32 maintain a snug fit within the outer cannula 22 so as toprevent movement of the inner cannula 32 during delivery into thesurgical site.

As stated above, expandable portion 40 can be constructed of polymer andshapeset materials such as, for example, polymer strips 42interconnected by a shapeset material 44 to form a flower-likestructure. That is, having pedals made of polymers connected together byshapeset material. It is contemplated that other material combinationsand shapes can be utilized. The shape of expandable portion 40 can bethe same or similar to the cross section of outer cannula 22 for ease inmaintaining the unexpanded configuration.

In assembly and use, anchoring cannula 20 is employed with a surgicalprocedure for treatment of a disorder affecting a section of bone, suchas a fracture, for example in the distal radius, tibial plateau orproximal humerus of a patient, as discussed herein. In use, to treat theaffected section, a medical practitioner obtains access to the bone inany appropriate manner, such as through incision and retraction oftissues. Once the bone is exposed the cannula can be used to create andenter an access port adjacent to a fracture to be treated. It isenvisioned that anchoring cannula 20 may be used in any existingsurgical method or technique including open surgery, mini-open surgery,minimally invasive surgery and percutaneous surgical implantation,whereby the site is accessed through a micro-incision, or sleeve thatprovides a protected passageway to the area. Once access to the surgicalsite is obtained, anchoring cannula 20 can be deployed so to deliver anagent, such as bone void filler/bone cement, to treat the condition,such as repair the fracture.

In one particular embodiment, use of the anchoring cannula 20 isdelivered into the surgical site adjacent to a fracture or a break in aportion of a bone such as the distal radius, tibial plateau or proximalhumerus as well as other bone sites. These bone sites have minimalcancelous bone and therefore when the cannula is inserted, it cannot beeasily stabilized and does not remain stationary. This unstabilizationcan cause imprecise disbursement of material, such as bone voidfiller/bone cement. To facilitate stabilization of the cannula,expandable portion 40 is used and when deployed is disposed between anexpanded configuration and an unexpanded configuration. When anchoringcannula 20 is inserted into the surgical site, expandable portion 40 isin its unexpanded configuration within the outer cannula 22. Once inposition, inner cannula 32 is advanced out of outer cannula 22 by movingactuator mechanism 50 from a first position to a second position so asto advance inner cannula 22 out of distal end 26 of outer cannula 22. Asinner cannula 22 exits distal end 26, expandable portion 40 begins toexpand. When expandable portion 40 is completely disposed outside ofouter cannula 22, expandable portion is in its fully expandedconfiguration. Expandable portion 40 stabilizes the cannula in place bypressing against the existing cancelous bone thereby allowing forprecise delivery of bone void filler/bone cement, or deployment of otheragents and/or surgical tools that may be required. For furtherstability, actuator mechanism 50 can be locked in place to furtherstabilize the cannula. When inner cannula 32 is retracted back intoouter cannula 22, expandable portion 40 collapses to its unexpandedconfiguration and the cannula system can be removed.

It is contemplated that in addition to bone void filler/bone cement,other agents can be delivered to a surgical site using anchoring cannula20. The se agents include therapeutic polynucleotides or polypeptides.It is further contemplated that these agents may also includebiocompatible materials, such as, for example, biocompatible metalsand/or rigid polymers, such as, titanium elements, metal powders oftitanium or titanium compositions, sterile bone materials, such asallograft or xenograft materials, synthetic bone materials such as coraland calcium compositions, such as HA, calcium phosphate and calciumsulfite, biologically active agents, for example, gradual releasecompositions such as by blending in a bioresorbable polymer thatreleases the biologically active agent or agents in an appropriate timedependent fashion as the polymer degrades within the patient. Suitablebiologically active agents include, for example, BMP, Growth andDifferentiation Factors proteins (GDF) and cytokines. The components ofanchoring cannula 20 can be made to include radiolucent materials suchas polymers. Radiomarkers may be included for identification underx-ray, fluoroscopy, CT or other imaging techniques. It is envisionedthat the agent may include one or a plurality of therapeutic agentsand/or pharmacological agents for release, including sustained release,to treat, for example, pain, inflammation and degeneration. It iscontemplated that the first or second cannula can include markers so asto determine the placement of the cannula in the surgical site.

It is envisioned that the use of microsurgical and image guidedtechnologies may be employed to access, view and repair bonedeterioration or damage, in conjunction with the anchoring cannula 20.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplification of thevarious embodiments. Those skilled in the art will envision othermodifications within the scope and spirit of the claims appended hereto.

What is claimed is:
 1. An anchoring cannula comprising: a first cannulahaving a proximal end, a distal end, a longitudinal axis and a lumenextending from the proximal end to the oppositely disposed distal endalong the longitudinal axis, and a second cannula concentricallyarranged within the lumen of the first cannula, the second cannulahaving a proximal end, a distal end, a lumen extending from the proximalend to the oppositely disposed distal end along the longitudinal axisand an expandable portion connected to the distal end that is configuredto expand when the second cannula is advanced out of the distal end ofthe first cannula and to return to an unexpanded configuration whenretracted back into the distal end of the first cannula.
 2. An anchoringcannula of claim 1, wherein the expandable portion of the second cannulais constructed, at least in part, of a shapeset material.
 3. Ananchoring cannula of claim 1, wherein the expandable portion of thesecond cannula is constructed of polymer and shapeset material and isconfigured to expand when the second cannula is advanced out of thedistal end of the first cannula and to change to an unexpandedconfiguration when retracted back into the distal end of the firstcannula.
 4. An anchoring cannula of claim 1, wherein the expandableportion comprises polymer strips interconnected by a shapeset materialto form a tapered configuration when unexpanded and to expand radiallywhen advanced from the first cannula.
 5. An anchoring cannula of claim1, further comprising an actuator member connected to the second cannulawherein moving the actuator from a first position to a second positionadvances the second cannula from the distal end of the first cannula andmoving the actuator from the second position back to the first secondposition retracts the second cannula back into the distal end of thefirst cannula.
 6. An anchoring cannula of claim 5, wherein the actuatormember further comprises a locking mechanism configured to lock thesecond cannula in a position with respect to the first cannula.
 7. Ananchoring cannula of claim 1, wherein the distal end of the firstcannula has a cutting edge.
 8. An anchoring cannula of claim 3 whereinthe polymer is selected from the group consisting of polyaryletherketone(PAEK) including polyetheretherketone (PEEK), polyetherketoneketone(PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO₄polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone,polyurethane, silicone-polyurethane copolymers based materials,polymeric rubbers, polyolefin rubbers, semi-rigid and rigid materials,thermoplastic elastomers, thermoset elastomers, elastomeric composites,rigid polymers including polyphenylene, polyamide, polyimide,polyetherimide, polyethylene, epoxy, and composites of metals andcalcium-based ceramics, composites of PEEK and calcium based ceramics,and combinations thereof.
 9. An anchoring cannula of claim 8 wherein theshapeset material is a Ni—Ti-based alloy such as Nitinol, an iron basedalloy such as Fe—Mn—Si or Fe—Ni—Co—T Cu—Al—Ni, Cu—Zn—Al and Fe—Mn—Si—Cr.10. An anchoring cannula comprising: an outer cannula having a proximalend, a distal end, a longitudinal axis and a lumen extending from theproximal end to the oppositely disposed distal end of the outer cannulaalong the longitudinal axis, each of the proximal and distal ends havingan opening therein, an inner cannula configured to fit within the lumenof the outer cannula having a proximal end, a distal end, a longitudinalaxis and a lumen extending from the proximal end to the oppositelydisposed distal end along the longitudinal axis, the distal end havingan expandable portion connected to the distal end that is configured toexpand when the inner cannula is advanced out of the distal end of theouter cannula and to collapse when retracted back into the outercannula, wherein the expandable portion is constructed of polymer andshapeset material and configured to expand when the inner cannula isadvanced out of the distal end of the outer cannula and to collapse whenthe retracted back into the outer cannula; an actuator member in contactwith the inner cannula wherein moving the actuator from a first positionto a second position extends and retracts the expandable portion of theinner cannula from the distal end of the outer cannula; and a lockingmechanism configured to lock the inner cannula to the outer cannula. 11.An anchoring cannula of claim 10, wherein the distal end of the outercannula has a cutting edge.
 12. An anchoring cannula of claim 10 whereinthe polymer is selected from the group consisting of polyaryletherketone(PAEK) including polyetheretherketone (PEEK), polyetherketoneketone(PEKK) and polyetherketone (PEK), carbon-PEEK composites, PEEK-BaSO₄polymeric rubbers, polyethylene terephthalate (PET), fabric, silicone,polyurethane, silicone-polyurethane copolymers based materials,polymeric rubbers, polyolefin rubbers, semi-rigid and rigid materials,thermoplastic elastomers, thermoset elastomers, elastomeric composites,rigid polymers including polyphenylene, polyamide, polyimide,polyetherimide, polyethylene, epoxy, and composites of metals andcalcium-based ceramics, composites of PEEK and calcium based ceramics,and combinations thereof.
 13. An anchoring cannula of claim 10 whereinthe shapeset material is a Ni—Ti-based alloy such as Nitinol, an ironbased alloy such as Fe—Mn—Si or Fe—Ni—Co—T, Cu—Al—Ni, Cu—Zn—Al andFe—Mn—Si—Cr.
 14. A method for treating a fracture comprising, insertingthe anchoring cannula of claim 1 into bone adjacent to a fracture;advancing the second cannula out of the distal end of the first cannulawherein expanding the expandable portion so that the at least a part ofthe expandable portion is in contact with bone so as to stabilize theanchoring cannula in place; treating the fracture adjacent to theanchoring cannula; and retracting the second cannula back into thedistal end of the outer cannula so as to collapse the expandable portionof the second cannula and removing the anchoring cannula from bone. 15.A method for treating a fracture in claim 14 further comprising the stepof orientating the second cannula so that the lumen faces the fractureprior to advancing the second cannula so as to expand the expandableportion.
 16. A method for treating a fracture in claim 15 wherein amaterial for treating the fracture is delivered through the lumen of thesecond cannula to the fracture.
 17. A method for treating a fracture inclaim 16 wherein the material for treating the fracture is selected fromthe group consisting of bone void filler, bone cement and bone graftmaterials.
 18. A method for treating a fracture comprising: insertingthe anchoring cannula of claim 10 into bone adjacent to a fracture;orientating the inner cannula so that the lumen of the inner cannulafaces the fracture; expanding the expandable portion of the innercannula so that it is in contact with bone so as to stabilize the innercannula in place; delivering a material to treat the fracture throughthe lumen of the inner cannula to the fracture and adjacent area; andcollapsing the expandable portion of the second cannula and removing theanchoring cannula from the bone.
 19. A method for treating a fracture ofclaim 14 wherein the fracture being treated is in a vertebrae, distalradius, proximal humerus and tibial plateau.
 20. A method for treating afracture of claim 18 wherein the fracture being treated is in avertebrae, distal radius, proximal humerus and tibial plateau.